Clinical Characterization of Parkinson s Disease Patients Followed at CHCB Comparison with a control group

Parkinson’s disease is the second most common neurodegenerative disease, characterized by four motor symptoms: rest tremor, bradykinesia, rigidity and postural instability. Diagnosis is made through strict clinical criteria, but clinical diagnosis is difficult in the early disease state and frequently does not allow a definitive diagnose. One hallmark of Parkinson’s disease is the death of the pigmented dopaminergic neurons of midbrain substantia nigra, with consequent loss of the neurotransmitter dopamine in the corpus striatum. The exact mechanisms underlying are still not understood and current theories include neuroinflammation and oxidative stress. Evidences suggest the presence of chronically activated microglia and several studies detected higher levels of their markers, namely cytokines and oxidative stress products. The main objectives of this study were to characterize CHCB’s Parkinson population, to evaluate inflammatory and oxidative markers and immunological status. Medical records were evaluated for patients (n=38) and healthy controls (n=32). Patient’s motor symptoms at onset and at evaluation were determined. The inflammatory markers measured were C reactive protein, erythrocyte sedimentation rate and serum cytokines (interleukins 1ß, 8, 6, 10, 12p70 and Tumor Necrosis Factor). Immunological status was accessed through leukogram. Urate was our oxidative marker. The cytokines measurement reveals values below the lower limits of detection for all. C reactive protein was higher in patients, but erythrocyte sedimentation rate was similar between both groups. In leukogram analysis, we detected higher values of neutrophils in patients. However, lymphocytes were the only that decrease throughout the temporal evolution of the disease and in patients using higher doses of L-DOPA. We attempted to clarify the real cause of lymphocytes decrease. Although there was a tendency to observe a lower number of lymphocytes for higher doses of L-DOPA in all phases of temporal evolution of the disease, the difference was not statistically significant. In relation to urate, we obtained lower values in patients and the decrease was marked in the higher stages of the disease and longer disease duration. Regarding inflammatory aspects of the disease, our study showed that cytokine pattern is not sensitive or specific to assess disease progression. On the other hand, the antioxidant urate presents us as a putative marker of disease severity.A doença de Parkinson é a segunda doença neurodegenerativa mais comum, caracterizando-se por quatro sintomas motores: tremor de repouso, bradicinesia, rigidez e instabilidade postural. O diagnóstico é feito através de rigorosos critérios clínicos, mas o diagnóstico clínico é difícil na fase inicial da doença e, frequentemente, não permite o diagnóstico definitivo. A Doença de Parkinson consiste na morte dos neurónios dopaminérgicos pigmentados da substantia nigra do mesencéfalo, com consequente perda do neurotransmissor dopamina no corpo estriado. Os mecanismos exatos subjacentes ainda não são compreendidos e as teorias atuais incluem mecanismos inflamatórios e de stress oxidativo. Evidências sugerem a presença de microglia cronicamente ativada, com diversos estudos mostrando níveis elevados de marcadores da microglia, nomeadamente citoquinas e produtos de stress oxidativo. Os principais objetivos deste estudo foram caracterizar a população de doentes do CHCB, avaliar os seus marcadores inflamatórios e oxidativos e o seu estado imunológico. Os processos clínicos foram avaliados para os doentes (n = 38) e controlos (n = 32). Os sintomas motores dos doentes no início da doença e no dia da avaliação foram registados. Os marcadores inflamatórios medidos foram a proteína-C-reativa, a velocidade de hemossedimentação e citoquinas séricas (interleucinas 1ß, 8, 6, 10, 12p70 e Fator de Necrose Tumoral). O sistema imunológico foi avaliado através do leucograma e o ácido úrico foi o marcador oxidativo utilizado. A medição das citoquinas revelou valores abaixo dos limites inferiores de deteção. A proteína-C-reativa foi superior nos doentes, mas a velocidade de hemossedimentação foi semelhante entre os grupos. Na análise do leucograma, detetamos valores superiores de neutrófilos nos doentes. No entanto, os linfócitos foram os únicos que diminuíram com a evolução temporal da doença e nos indivíduos que utilizavam maiores doses de L-DOPA. Na tentativa de esclarecer a verdadeira causa dessa diminuição, detetámos que, embora houvesse uma tendência a se observar um menor número de linfócitos para altas doses de L-DOPA em todas as fases de evolução temporal da doença, a diferença não foi estatisticamente significativa. Em relação ao ácido úrico, obtiveram-se valores menores nos doentes, sendo a diminuição superior nos estágios mais elevados e na maior duração da doença. Relativamente aos aspetos inflamatórios da doença, os nossos resultados mostraram que o padrão de citoquinas não é sensível ou específico para avaliação da progressão da doença. Por outro lado, o ácido úrico apresenta-se como um possível marcador da severidade da doença

Mechanisms of femtosecond laser-induced refractive index modification of poly(methyl methacrylate)

The mechanisms of refractive index change in poly(methyl methacrylate) by frequency doubled femtosecond laser pulses are investigated. It is demonstrated that positive refractive index modificaton can be caused by a combination of depolymerization and crosslinking

Trabajo Monográfico para optar al título de Licenciatura en Turismo Sostenible “Potencialidad del Turismo Cultural en la Ciudad de Masaya; período Junio 2014-Mayo 2015

En este documento encuentra información acerca de la “Potencialidad del Turismo Cultural en la Ciudad de Masaya” y la estrecha relación que existe entre la elección de los turistas con altos conocimientos intelectuales y este tipo de turismo. En el primer capítulo se caracterizan los recursos Histórico-Culturales que posee la Ciudad de Masaya y que pueden ser motivadores principales para los desplazamientos. En el segundo capítulo se determinan los principales factores que limitan el desarrollo del Turismo Cultural en la ciudad de Masaya. En el tercer capítulo se proponen estrategias que faciliten el desarrollo del Turismo Cultural en la ciudad de Masaya. Masaya es una ciudad con altas posibilidades de desarrollar el turismo cultural, contando con recursos históricos-culturales, que pueden ser aprovechados en el mercado turístico no solo por las grandes edificaciones que posee sino también por su gastronomía única, además de las tradiciones arraigadas de sus antepasados y de cuidar siempre cada detalle de las celebraciones realizadas, de platos elaborados, cuadro pintado, madera tallada, hilos que llegan a ser una gran obra de arte que hacen de Masaya una ciudad escultural enriquecida por el carisma de su pueblo. Todo esto se pudo constatar mediante un detenido estudio de esas cualidades históricas culturales que hacen que Masaya sea por si sola un producto turístico viable y sustentable

Bite and Sight: Is There a Correlation? Clinical Association between Dental Malocclusion and Visual Disturbances in Pediatric Patients

Aim: The aim of this study was to evaluate the correlation between malocclusions and visualdefects. Thisisacase-controlstudyevaluatingtheprevalenceofvisualdefectsinpatientswith di\ufb00erent types of malocclusions. Methods: One-hundred and sixty patients aged from 5 to 14 were evaluatedusingtheROMAindextodetectmalocclusion;theoneswiththelowestscoreswereusedas the control group. They were also submitted to visual-capacity inspection for motility and refractive disorders. Results: Our work showed an enhanced prevalence of refractive defects or fusional vergence defects and alteration of eye movements (especially the saccades) in almost all dental malocclusions. Statistics: TheKappatestvaluesforROMAindexwerebetween0.643and1.00forthe intraoperator agreement (0.00 < p < 0.002) and between 0.773 and 1.00 for the agreement between operators (p = 0 < 0.001). The statistically signi\ufb01cance level for the correlation malocclusion/visual defectswassetatp < 0.05. StatisticalanalyseswereperformedwiththeSTATAsoftware(version15.0, Stata Corp LP, College Station, TX, USA). Conclusion: Considering the high level of the statistical analysis and the accuracy of the methodology used, these data allows the establishment of a huge correlation between sagittal, transversal and vertical malocclusions with ocular disorders (myopia, hyperopia, astigmatism and ocular motility defects)

Límite de una función en un punto y en el infinito

Presentamos un material interactivo realizado con Descartes y Geogebra, dirigido a los estudiantes de un primer curso de cálculo diferencial, en los programas de Ingeniería que se imparten en la Universidad Autónoma de Querétaro. Con estos materiales se estudian los conceptos de límite de una función en un punto y límite de una función en el infinito. Aunque en ambos casos se parte de una idea intuitiva de esos conceptos, el objetivo fundamental de este material es llegar a obtener una definición formal de los mismos y facilitar la comprensión de esa definición de una manera visual. En este documento también plasmamos los resultados obtenidos una vez que se han aplicado a un grupo de estudiantes dichos materiales

Uso de pantallas Smartphone y sus efectos en la acomodación visual de las estudiantes becadas internas del recinto universitario Rubén Darío de la UNAN-Managua, en el período de Julio a septiembre 2019

El uso de smartphones por parte de los jóvenes universitarios aumenta cada día, la alta dependencia hacia esos dispositivos, aumentan horas de exposición a la radiación lumínica emitida por los mismos, lo que induce efectos negativos en el sistema visual. Leer más de veinte minutos en un smartphone en lugar de hacerlo en papel empeora nueve de diez síntomas oculares y visuales analizados en una investigación realizada por la Universidad Complutense de Madrid, entre ellos visión borrosa, fatiga visual y ojos secos o irritados y daños en la acomodación (Bautista, 2016).El propósito de esta investigación fue determinar los efectos que generan el uso de pantallas smartphone en la acomodación visual; el estudio fue de tipo descriptivo y correlacional, donde se evaluó la función acomodativa determinadas en 175 estudiantes becadas internas del recinto universitario Rubén Darío de la UNAN-Managua, expuestas a estos dispositivos, analizándose aspectos de su uso como, la distancia de lectura, niveles de brillo, tiempo de exposición a la pantalla del smartphone, síntomas de las estudiantes y exámenes de acomodación. La investigación refleja que los altos niveles de brillo del celular en condiciones nocturnas influyen de manera negativa con amplitud de acomodación, flexibilidad de acomodación visión próxima y ARP. Además, el nivel de brillo del celular durante el día genera alteraciones en amplitud de acomodación, flexibilidad de acomodación y acomodación relativa. El uso excesivo de exposición visual al smartphone, mayor a 9 horas diarias generan alteraciones en amplitud de acomodación, flexibilidad de acomodación visión próxima, determinación del retardo acomodativo y acomodación relativa. Los síntomas de mayor prevalencia fueron asintomáticos, ardor ocular y visión borros

How much European prescribing physicians know about invasive fungal infections management?

The use of systemic antifungal agents has increased in most tertiary care centers. However, antifungal stewardship has deserved very little attention. Our objective was to assess the knowledge of European prescribing physicians as a first step of an international program of antifungal stewardship. Methods: Staff physicians and residents of 4 European countries were invited to complete a 20-point questionnaire that was based on current guidelines of invasive candidiasis and invasive aspergillosis. Results: 121 physicians (44.6% staff, 55.4% residents) from Spain 53.7%, Italy 17.4%, Denmark 16.5% and Germany 12.4% completed the survey. Hospital departments involved were: medical 51.2%, ICUs 43%, surgical 3.3% and pharmaceutical 2.5%. The mean score of adequate responses (± SD) was 5.8 ± 1.7 points, with statistically significant differences between study site and type of physicians. Regarding candidiasis, 69% of the physicians clearly distinguished colonization from infection and the local rate of fluconazole resistance was known by 24%. The accepted indications of antifungal prophylaxis were known by 38%. Regarding aspergillosis, 52% of responders could differentiate colonization from infection and 42% knew the diagnostic value of galactomannan. Radiological features of invasive aspergillosis were well recognized by 58% of physicians and 57% of them were aware of the antifungal considered as first line treatment. However, only 37% knew the recommended length of therapy. Conclusions: This simple, easily completed questionnaire enabled us to identify some weakness in the knowledge of invasive fungal infection management among European physicians. This survey could serve as a guide to design a future tailored European training program

Body composition study by dual-energy x-ray absorptiometry in familial partial lipodystrophy: finding new tools for an objective evaluation (vol 4, pg 40, 2012)

Rio de Janeiro & Catholic Univ, Inst Estadual Diabet & Endocrinol, Metab Unit, Rio de Janeiro, BrazilUniv Fed Rio de Janeiro, Dept Nutrol, Rio de Janeiro, RJ, BrazilUniversidade Federal de São Paulo, Div Endocrinol, São Paulo, SP, BrazilInst Estadual Diabet & Endocrinol, BR-20211340 Rio de Janeiro, RJ, BrazilUniversidade Federal de São Paulo, Div Endocrinol, São Paulo, SP, BrazilWeb of Scienc

Virtualización de sistemas gestores de cómputo en las organizaciones.

At present, the demand for services by users is increasing. Because of this, companies require more infrastructure that allows them to meet this need, however, sustaining the required infrastructure in a conventional manner results in a significant increase for the company's costs. This is where virtualization is required, because it allows companies to perform conventional tasks without the need for physical resources. For this reason, the present research shows the advantages of virtualizing resources within companies.En la actualidad la demanda de servicios por parte de los usuarios es cada vez mayor. Como consecuencia de esto, las empresas requieren de mayor infraestructura que les permita hacer frente a esta necesidad, sin embargo, sustentar la infraestructura requerida de manera convencional resulta en un incremento significativo para los costos de la empresa. Es aquí donde la virtualización se requiere, debido a que permite a las empresas realizar las tareas convencionales sin la necesidad de contar con los recursos físicos. Por tal motivo, en la presente investigación se plasman las ventajas que conlleva la virtualización de los recursos dentro de las empresas